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Neuro Test 2 > Anatomy: Face, Scalp, Parotid gland > Flashcards

Anatomy: Face, Scalp, Parotid gland Flashcards

1
Q

5 layers of skin?

A

S: skin
C: CT - dense - contains vessels and nn.
A: aponeurosis epicranius
L: loose CT - usually this is plane during scalp injury
P: pericranium (periosteum, outer CT of flat bones of skull)

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2
Q

why do scalps bleed so much?

A

scalp is highly vascular and because the vessels are embedded within the dense ct of layer 2 there is limited constriction when lacerated. There are many anastomoses as well, and there is no single vessel to compress to stop the bleeding.

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3
Q

how is scalp innervated?

A

spinal nerves posterior portion of head

trigeminal n. anterior portion of head

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4
Q

what are spinal nn. innervating scalp?

A

greater occipital: straight middle back of head
C3: inferior posterior scalp
Lesser occipital: behind ear
great auricular: underneath ear

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5
Q

what cranial nn. innervate scalp?

A

Trigeminal branches:
auriculotemporal of V3 (in front of ear and up)
zygomaticotemporal V2 (temple and up)
supraorbital V1 (forehead and above eyes)
supratrochlear branch of V1 (nose/midline forehead)

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6
Q

what is the arterial supply of the scalp?

A

from external carotid a: occipital, posterior auricular, superficial temporal

from internal carotid a: supraorbital a, supratrochlear a.

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7
Q

how does scalp drain?

A 
vena comitantes of aa. 
emissary vv (drain through bones of skull to dural venous sinuses)
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8
Q

why are scalp infections potentially dangerous?

A

scalp infection/bleeding can spread easily within the loose connective tissue layer (layer 4); can spread within the eyelids and dorsum of the nose and cause “ecchymosis” (extravasation of blood under skin).

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9
Q

how are facial expression muscles innervated?

A

SVE portion of facial n.

- all are derived from pharyngeal arch 2

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10
Q

orbicularis oculi

A

muscles associated with eyes/eyebrows
- orbital part: surrounds orbit and forcefully closes eye
palpebral portion: within eyelid to gently close eye
lacrimal portion: within medial corner of eye, helps with lacrimal fluid drainage

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11
Q

corrugator supercilli

A

draws eyebrows down and in - worried look

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12
Q

occipitofrontalis

A

muscles associated with scalp and forehead

  • frontal belly: elevates eyebrows, wrinkles skin of forehead
  • occipital belly- retract scalp, helps with “suprised” expression
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13
Q

orbicularis oris

A

closes lips/mouth

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14
Q

buccinator

A

keeps cheeks in contact with gums to food does not accumulate in vestibule of mouthg

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15
Q

levator labii superioris

A

elevates upper lip

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16
Q

levator anguli oris

A

elevates upper lip; widens mouth

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17
Q

zygomaticus major

A

elevates upper lip “main smile muscle”

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18
Q

zygomaticus minor

A

elevates upper lip

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19
Q

risorius

A

stretches lips laterally into wide muscle

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20
Q

levator labii superioris alaeque nasi

A

elevates upper lip and flares nostrils

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21
Q

depressor anguli oris

A

depresses lower lip; frown

22
Q

depressor labii inferioris

A

depresses lower lip; pout/frown

23
Q

mentalis

A

protrudes lower lip: pout mm.

24
Q

procerus

A

wrinkles skin over dorsum of nose

25
Q

nasalis

A

flares nostrils

26
Q

platysma

A

depresses mandible, tenses skin of lower face and neck

27
Q

where does facial nerve travel?

A

exits brainstem and enters internal acoustic meatus. courses laterally between cochlea and semicircular canals and along posterior wall of middle ear, exits facial canal via stylomastoid foramen

28
Q

branches of facial nerve?

A
  1. posterior auricular n. - supplies occipital belly of occipitofrontalis
  2. digastric n.
  3. stylohyoid n.
  4. temporofacial trunk:
    - temporal branch (above eye),
    - zygomatic branch (side of eye/upper cheek)
    - buccal branch (to nose/mouth)
  5. cervicofacial trunk:
    - buccal branches (transversely across face)
    - marginal mandibular branches (lower mandible border)
    - cervical branch (to platysma )
29
Q

Bell’s Palsy

A

= facial n. paralysis

  • many cases are idiopathic; although linked to herpes virus, trauma or lesion along course of nerve
  • results in paralysis of facial expression
  • facial asymmetry and drooping
  • drooping of lower eyelid causes drainage of tears and ulceration of eye
  • paralysis of orbicularis oris causes dribbling of saliva from mouth
  • loss of buccinator = food accumulation within cheek and teeth
  • impaired speech
30
Q

What does V1 supply?

A

opthalmic nerve

  • skin of forehead, upper eyelid, nose
  • branches: supratrochlear n. supraorbital n, lacrimal n, infratrochlear n, external nasal n.
31
Q

What does V2 supply?

A

Maxillary n.
- provides skin of temporal region, upper cheek and lip, lower eye lid, ala of nose
Branches: zygomaticotemporal, zygomaticofacial, infraorbital n.

32
Q

what does V3 supply?

A

mandibular nerve

  • lower cheek, lower lip, chin
  • provides: auriculotemporal n, buccal n, mental n.
33
Q

trigeminal neuralgia

A

a neurological condition characterized by episodes of brief, intense facial pain over an area of CN V distribution.

  • cause believed to be demyleination of axons within the sensory root of CNV. some cases can be due to compression by the superior cerebellar a.
  • divisions affected: V2>V3>V1
34
Q

nerve block administration?

A
  • infraorbital n: injected around infraorbital foramen
  • mental n: injected around the mental foramen on chin
  • buccal n: injected via the oral vestibule just posterior to the 3rd mandibular molar
35
Q

hepres zoster

A

often affects the trigeminal ganglion

  • due to reactivation of previous infection of dorsal root or sensory ganglion by varicella zoster virus
  • rash confined to one dermatome
  • most often affects V1 and can lead to scarring/ulceration of cornea
36
Q

facial artery?

A
  1. facial artery: branches from external carotid, through submandibular gland, arches over mandible just anterior to masseter to enter face. takes tortuous course along angle of mouth to lateral side of nose/medial eye angle (gives off: inferior and superior lalbial branches, lateral nasal and angular a.)
37
Q

superficial temporal artery?

A

terminal brnch of external carotid a.

- gives off transverse facial a, frontal branches and parietal branches.

38
Q

maxillary a?

A

branch off of external carotid a.

- gives infraorbital a, buccal a, and mental a.

39
Q

opthalmic a.

A 
branch of internal carotid a. 
- gives off: 
supraorbital
supratrochlear
middle palpebral
lacrimal
dorsal nasal a.
40
Q

retromandibular vein

A

formed from union of superficial temporal and maxillary vv.

  • divides ant/post division
  • anterior division merges with facial v.
  • posterior division merges with posterior auricular v. to form the external jugular v.
41
Q

facial v.

A

begins at medial corner of eye as angular v.

  • joins anterior division of retromandibular v. to make common facial v. which then drains to IJV
  • communicates with deeper plexuses: with pterygoid plexus via deep facial v, with cavernous sinus via opthalmic vv.
42
Q

infection from face

A

the central face area is a “danger area” for infection to travel into the skull or deep face b/c the facial v. anastamoses with pterygoid plexus and cavernous sinus

43
Q

lymphatic drainage

A
  • lymph drains to submental, submandibular, parotid lymph nodes
  • all ultimately flow to deep cervical lymph nodes along internal jugular v.
44
Q

where does parotid duct exist?

A
  • leaves anterior border of gland and crosses the masseter muscle - pierces buccinator muscle and mucosa of cheek to enter the oral cavity opposite the 2nd upper molar tooth
  • abcesses or infections of dental origin may spread to the parotid gland via the parotid duct
45
Q

what are important structures embedded within the parotid gland?

A
  1. facial n.
  2. retromandibular v.
  3. external carotid a.
  • during parotidectomy these structures must be isolated and protected in order to preent damage.
46
Q

what are chief complaints of problems with the parotid gland?

A

eyes dry and red
dry mouth
eyes are droopy

47
Q

Parasympathetic innervation of parotid gland?

A

Preganglionic: glossopharyngeal nerve with cell bodies located in salivatory nucleus in brain stem

  • CN IX exits at jugular foramen and gives a tympanic branch, the tympanic n. then enters the middle ear via tympanic canaliculuous. Travels through the middle ear and transforms into lesser petrosal n. Lesser petrosal n.
  • Lesser petrosal n. in the middle cranial fossa exits via the foramen ovale, once in the infratempora fossa it synapses in otic ganglion.

Postganglionic: Cell bodies are located in otic ganglion. Postganglionic fibers travel with auriculotemporal branch of V3

Function: stimulates grand secretion from parotid gland

48
Q

sympathetic innervation to parotid gland

A

preganglionic cell bodies located in spinal cord at levels T1-4
Postganglionic cell bodies in superior cervical symp. ganglion
- postganglionic fibers travel with external carotid n. to parotid tissue

function: vasomotor: alters type of secretion

49
Q

Parotiditis

A

inflammation of the parotid gland

  • painful due to stretching of parotid sheath
  • pain can be carried via V3 and great auricular n.
  • often pain will “refer” to auricle, TMJ and external acoustic meatus
50
Q

sialolith

A

calcified concretion that can sometimes form in the parotid gland
if it passes into the parotid duct the duct can become blocked and it is quite painful

Neuro Test 2 (13 decks)

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